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- Required Information

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It is strongly encouraged that all applicants read the application instructions BEFORE completing the PTCAS application. Click here to download the application instructions in PDF format. For instructions on how to complete this section, please click the "Instructions for This Section" link at the top of this page.

User Information
Title:
(e.g., Dr., Mr., Ms., Mrs., Miss, Rev.)
First Name: 
Nickname/Preferred First Name:
Middle Name:
Last (Family) Name: 
Suffix (Jr, IV, etc):
(e.g., Jr., Sr., II, III, etc.)
Prior/Alternate/Maiden Last Name:
Social Security Number:

(xxx-xx-xxxx) - You are strongly encouraged to enter your US Social Security Number in order to avoid delays in the matching of your official GRE scores to your PTCAS application. Your designated PT programs may also require your SSN for institutional or federal financial aid forms. See PTCAS privacy and security policies at http://www.ptcas.org/Privacy.html.
Email Address: 
Confirm Email Address: 
Security Question: 
Security Answer: 
By checking this box, you authorize PTCAS to release your name and contact information to your designated PTCAS programs BEFORE you e-submit your final application to PTCAS. This will allow your designated programs to send you important information about the local admissions process before you complete your PTCAS application:
Account Information
Username: 
Please choose a username that is between 6 and 15 characters long
Password: 
Create a unique password that is 6 to 10 characters long. It can include letters, numbers and special characters [. , _ , -]. Password is Case Sensitive. Try to create a password that is easy to remember, but not easily guessed by others.
Confirm Password: 
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